 
                            If You Could Give Me Your Clinical Opinion On A Diagnosis?
 
 
                                    
                                    
                                          
                                               Posted on
                                          
                                            
                                         
                                           Fri, 19 Feb 2021
                                           
                                        
                                        
                                        
                                            Medically reviewed by
                                            
                                                  Ask A Doctor - 24x7 Medical Review Team
                                            
                                        
                                        
                                             Fri, 19 Feb 2021
                                                
                                            
                                                Answered on
                                                
                                                Fri, 19 Feb 2021
                                                
                                            
                                                Answered on
                                             
                                             Thu, 20 Feb 2025
                                                
                                                
                                                Last reviewed on
                                                
                                                Thu, 20 Feb 2025
                                                
                                                
                                                Last reviewed on
                                             
                                            Question : Hi there, I was wondering if you could give me your clinical opinion on a diagnosis. Here is my current symptoms and background: 
Current/recurring symptoms:
- Swelling in wrists and ankles - happens to both joints at the same time but worse in left. Stiff in mornings. Compression gloves help with swelling, if not used they can balloon.
- Pain and heat in knees.
- Ulnar pain can be extreme - worse in left.
- Redness across the face and nose when experiencing other symptoms.
- Nose goes bright red with any sun exposure.
- Frequent rashes - circular marks on upper legs, they occasionally present like a purpura rash (dots)
- TMJ.
- Reynauds.
- Seizure like episodes over the years - confusion/black outs.
- Frequent dystonia.
- Tremor - worse when tired.
- Fatigue - can be extreme and debilitating.
- Hip pain - both but more frequently the right.
- Blood blisters in mouth, angular cheilitis occasionally.
- Flu like symptoms - temperature all over the place and occasional night sweats.
History:
- Had a few positive ANA tests with speckled patterns. Also had a few negative tests when not experiencing inflammatory symptoms.
- Had a 12 month long episode of treatment resistant TTP (2008) - Pos ANA during admission. Surgical removal of large (grapefruit sized) ovarian benign tumour during treatment. Daily plasmapheresis not effective until high dose steroids were added.
- Had TIA (2011) which resulted in chronic neuropathic pain and a diagnosis of fibromyalgia.
- Fibromyalgia pharmaceuticals were ineffective - made the decision to swap to medical cannabis combined with other anti inflammatory herbs and supplements.
- Fibromyalgia symptoms still present but better controlled with cannabis. None-typical fibromyalgia (more inflammatory) symptoms have escalated and progressed over the years.
                            Current/recurring symptoms:
- Swelling in wrists and ankles - happens to both joints at the same time but worse in left. Stiff in mornings. Compression gloves help with swelling, if not used they can balloon.
- Pain and heat in knees.
- Ulnar pain can be extreme - worse in left.
- Redness across the face and nose when experiencing other symptoms.
- Nose goes bright red with any sun exposure.
- Frequent rashes - circular marks on upper legs, they occasionally present like a purpura rash (dots)
- TMJ.
- Reynauds.
- Seizure like episodes over the years - confusion/black outs.
- Frequent dystonia.
- Tremor - worse when tired.
- Fatigue - can be extreme and debilitating.
- Hip pain - both but more frequently the right.
- Blood blisters in mouth, angular cheilitis occasionally.
- Flu like symptoms - temperature all over the place and occasional night sweats.
History:
- Had a few positive ANA tests with speckled patterns. Also had a few negative tests when not experiencing inflammatory symptoms.
- Had a 12 month long episode of treatment resistant TTP (2008) - Pos ANA during admission. Surgical removal of large (grapefruit sized) ovarian benign tumour during treatment. Daily plasmapheresis not effective until high dose steroids were added.
- Had TIA (2011) which resulted in chronic neuropathic pain and a diagnosis of fibromyalgia.
- Fibromyalgia pharmaceuticals were ineffective - made the decision to swap to medical cannabis combined with other anti inflammatory herbs and supplements.
- Fibromyalgia symptoms still present but better controlled with cannabis. None-typical fibromyalgia (more inflammatory) symptoms have escalated and progressed over the years.
                                    Brief Answer:
It seems like lupus.
Detailed Answer:
Hello ,
I read your clinical history and symptoms and the tests done and it seems like you are having lupus and fibromyalgia.
I think you may need to visit a rheumatologist and discuss for immunosuppressive therapy.
Hope I have answered the question.
Let me know if I can assist you further.
Thanks.
                                    
                            It seems like lupus.
Detailed Answer:
Hello ,
I read your clinical history and symptoms and the tests done and it seems like you are having lupus and fibromyalgia.
I think you may need to visit a rheumatologist and discuss for immunosuppressive therapy.
Hope I have answered the question.
Let me know if I can assist you further.
Thanks.
 Above answer was peer-reviewed by :
                              
                            
                                  
                                      Dr. Raju A.T
                                  
                              
                                          
 
                                    
                                    
                                 
  
 
                                    Thank you, I was considering the same. I'm resistant to immune suppressants. Would a biologic agent have less side effects? 
Thanks for your time
                            Thanks for your time
                                    Brief Answer:
You may need to try it.
Detailed Answer:
Hello dear and thank you for asking again .
You can try to use any biologic drug against lupus.
They have less side effects and are worthy trying in your case.
Let me know if I can assist you further.
                                    
                            You may need to try it.
Detailed Answer:
Hello dear and thank you for asking again .
You can try to use any biologic drug against lupus.
They have less side effects and are worthy trying in your case.
Let me know if I can assist you further.
 Above answer was peer-reviewed by :
                              
                            
                                  
                                      Dr. Raju A.T
                                  
                              
                                          
 
                                    
                                    
                                 
 Answered by
 
                                                    Get personalised answers from verified doctor in minutes across 80+ specialties
 
                         Sign in with Google
 Sign in with Google 
  
                                 
                                